The Study To Explore The Risk Factors Influencing In Type 2 Diabetes Associated With Nonalcoholic Fatty Liver And Initially Analyse The Causes Of It

ObjectiveTo explore factors influencing in type 2 diabetes (T2DM)associated with nonalcoholic fatty liver(NAFLD) and initially analyse the causes of NAFLD in type 2 diabetic inpatients in Tianjin.MethodsA total of 1007 hospitalized patients with T2DM were divided into T2DM without NAFLD group(Group A) and T2DM with NAFLD group (Group B) to analyse the data between them. Collect demographic data (include age, sex, duration and so on) and clinical and laboratory examination (include height, weight, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, glycated hemoglobin Alc, fasting insulin, fasting C-peptide, triglyceride, total cholesterol, low-density lipoprotein, high-density lipoprotein serum uric acid and 24h urinary albumin and so on); ECG,color Doppler of heart and type-B ultrasonic of liver; calculate the body mass index(BMI),homeostasis model assessment—insulin resistance (HOMA-IR),early insulin secretion index,creatinine clearance rate,fractional excretion of uric acid,Estimated glomerular filtration rate (eGFR) and so on. We analysed:1 The prevalence of NAFLD in all patients and compare differences of the prevalence of NAFLD in different sex, different age and different diabetic duration;2 Compare the general clinical data and lab examination data in type 2 diabetes with and without NAFLD;3 Analyse the correlation of each risk factprs with NAFLD.Then 80 patients from both the two groups were randomly chosen, and the free fatty acid (FFA) and leptin level were measured.Results1 The prevalence of NAFLD:29.29% met the diagnostic criteria of NAFLD in 1007 type 2 diabetic patients. The prevalence of NAFLD was higher in women than in men(28.24% vs 30.63%), there is no significant difference(x2=0.684, P=0.408); With increasing age, the prevalence of MS reduced (χ2=33.729, P<0.001); With increasing duration, the prevalence of MS reduced (χ2=17.862, P<0.001);2 Compared with patients in Group A, the mean values levels of age, course of T2DM; uric acid clearance rate were significantly lower (p<0.05); BMI, SUA, alanine aminotransferase (ALT),γ-glutamyltranspeptidase (GGT), aspartate aminotransferase(AST) were significantly higher(P<0.05);3 With the increasing of age and duration(<5 years,5-10 years,> 10 years), the prevalence of NAFLD reduced significantly(P<0.000); With the increasing of BMI,enzyme in liver (including ALT,AST and GGT),SUA, the prevalence of NAFLD increased significantly(P<0.000); and there is no significant difference between high blood pressure,coronary heart disease,smoking and NAFLD(P>0.05);4 There is no significant difference between FFA,leptin and NAFLD(P>0.05)Conclusion1 The prevalence of NAFLD is 29.29%, which remind us notise the early screening of NAFLD in the women of post-menopause and the old people, inhence the education of DM, to control various kinds of abnormality of metabolism;2 There are negative correlations between age and duration with NAFLD, and positive correlation between ALT,AST,GGT,SUA and MS with NAFLD, which remind us not only to control the blood glucose level but also notise the treatnment of high blood pressure,coronary heart disease,abnormality of lipid metabolism and the life style in patients with T2DM.3Though there is no significant difference between the high blood pressure,coronary heart disease and smoking with NAFLD, but we can not ignore the damage of the great vessels and the blood capillary;4 There is no significant difference between FFA,leptin and NAFLD, the effect of FFA and leptin in the relestionship between SUA and NAFLD still need further study.